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General NPI Number Information
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NPI Number | 1508034844
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Entity Type | Individual
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Provider Name | AMALIA HILDEGARD GROSKLAUS LMP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 5702 N 33RD ST UNIT 22-C
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City | TACOMA
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State | WA
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Zip | 98407-2500
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Country | US
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Telephone | 253-297-7808
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Fax |
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Provider Business Mailing Address
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Address Line | 5702 N 33RD ST UNIT 22-C
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City | TACOMA
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State | WA
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Zip | 98407-2500
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Country | US
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Telephone | 253-297-7808
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Fax | 253-752-6779
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA00024688
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License Number State | WA
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